The Service Employees International Union (SEIU), AFL-CIO, strongly supports the need for OSHA
to finally issue their long delayed standard to protect healthcare and other workers from occupational exposure to tuberculosis, and to indirectly protect patients, clients, residents, and other members of the general public that share these same workplace environments.

SEIU represents 1.5 million workers in a wide range of occupations; many that encounter tuberculosis exposures on-the-job. SEIU is also largest union of healthcare workers, representing 755,000 doctors, nurses, nurse aides, laboratory workers, emergency medical technicians, nursing home workers, homecare workers and many other job classifications within the healthcare sector.

SEIU and others concerned about the occupational spread of tuberculosis petitioned OSHA in August 1993 for tuberculosis prevention standard. We were told then told by OSHA officials that this standard was to have been "fast tracked." It has now been nine long years.

Since this time, thousands of healthcare and other workers have needlessly become exposed and infected with the tuberculosis bacillus that they will carry within their bodies for the rest of their lives. Once exposed and infected, many of these workers are offered harsh medications with significant adverse side effects. Other workers employed in some of the highest risk settings, such as nursing homes and the homecare industry, frequently have no health insurance, and therefore are denied access to any medical treatment.

The anxiety of being infected, while seemingly discounted by those in the position to prevent infections, can be personally devastating, with workers fearing that they may eventually develop an active case of tuberculosis disease. However, like a ticking time bomb, their fears are not unfounded, as many of these workers will go on to develop tuberculosis disease as they age and/or their immune systems become weakened by other medical conditions.

In reviewing OSHA's Draft Final Risk Assessment, even with the reduction in estimated cases, the risk of tuberculosis infection clearly meets the legal definition of what would constituent a "material impairment of health," using both a reasonable person, as well as the U.S. Supreme Court's standard. In such cases, OSHA is legally bound under the Occupational Health and Safety Act of 1970 to act to assure that "no employee will suffer material impairment to their health." Furthermore, OSHA's Draft Final Risk Assessment clearly illustrates that control measures to prevent the occupational transmission of tuberculosis are both feasible and effective in protecting workers.

It has been illuminating, yet frustrating, to witness the many levels of government that have leapt into action to confront the potential threat posed by smallpox; and what steps are necessary to protect healthcare and other frontline workers from such a terrorist plot. While it is important to protect these workers from the potential threat posed by smallpox, where is our government's commensurate response to protect some of these very same workers from the very real and existing threat posed by tuberculosis?

As stated by expert reviewer of the Draft Final Risk Assessment, Richard Menzies: "there is sufficient evidence to conclude there is a real risk of occupational tuberculosis infection, so OSHA and other regulatory agencies have a duty to act."

Healthcare and other exposed workers on the frontlines deserve no less from their government. OSHA needs to act today to issue their final tuberculosis standard without further delay.